Provider Demographics
NPI:1184877615
Name:BOYD, MOLLY REBEKAH (PHD)
Entity type:Individual
Prefix:DR
First Name:MOLLY
Middle Name:REBEKAH
Last Name:BOYD
Suffix:
Gender:
Credentials:PHD
Other - Prefix:DR
Other - First Name:MOLLY
Other - Middle Name:R
Other - Last Name:BOYD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:820 JORDAN ST STE 465
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71101-4526
Mailing Address - Country:US
Mailing Address - Phone:318-557-5519
Mailing Address - Fax:
Practice Address - Street 1:820 JORDAN ST STE 465
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71101-4526
Practice Address - Country:US
Practice Address - Phone:318-557-5519
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-28
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMFT1152106H00000X
LA3758101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist